Self / Southern California Reproductive Center

Fertility Treatments and Heart Disease Study: Here’s the Truth

March 14, 2017

woman-356141_1920There’s no guarantee of success with fertility treatments, and it can be painful for couples to go through the time, emotional energy, and money involved in treatments without becoming pregnant. Now, a new study has found a correlation between unsuccessful fertility treatments and a higher risk of heart disease later in life. But before you freak out about his, there are a few things you should know.

The study, which was published in the Canadian Medical Association Journal, analyzed data from more than 28,000 women under 50 who underwent gonadotropin-based fertility therapy (an ovulation-stimulating hormonal therapy that is commonly used in in-vitro and intrauterine insemination treatments) between 1993 and 2011. Nearly 33 percent of those women gave birth a year after receiving treatments, but 67 percent did not. Of those women who didn’t give birth, the annual rate of having heart disease, including heart failure and stroke, later in life was 19 percent higher than those who had babies after undergoing treatment. However, researchers didn’t find a link between the number of fertility treatments a woman underwent and her heart disease risk.

The news sounds scary for women who have undergone fertility treatments or plan to one day–especially given that heart disease is the leading cause of death for women in the United States, per data from the Centers for Disease Control and Prevention. But while the study is grabbing headlines, it’s important to keep this in mind: The overall risk of developing heart disease for all of the women–whether they had a baby or not–was fairly low. For every 1,000 women who didn’t have a baby, there were about 10 heart disease-related incidences. By comparison, women who did have a baby had six cardiovascular events for every 1,000 births. Additionally, this study only shows a correlation, not a causation–which means that it’s not necessarily the fertility treatments that are causing the increased risk.

A heart disease risk exists, but fertility treatment may not be the cause.

Clearly, there is an increased risk of heart disease for women who didn’t have a successful pregnancy, but it’s relatively low. However, it exists and the study’s researchers say it may be more of a case of pre-existing heart conditions or a predisposition to heart disease that is discovered through fertility treatments. The treatments, then, may “merely unmask a latent predisposition to premature cardiovascular disease among individuals at risk of infertility,” they write.

Nicole Weinberg, M.D., a cardiologist at Providence Saint John’s Health Center in Santa Monica, California, who was not involved with the study, agrees. “Pregnancy is a woman’s first real stress test and a first real understanding of her vascular health,” she tells SELF. “These women may have increased risks of cardiovascular disease by nature, and this is our first inkling of it.”

Age can also be a factor, Janet Choi, M.D., a reproductive endocrinologist with Colorado Center for Reproductive Medicine’s New York location, tells SELF. “Women who require and fail to conceive with fertility treatment tend to be older and, therefore, more likely to have other potentially undiagnosed medical issues which could increase their risk for later life cardiovascular events,” she says. Women in the study who didn’t give birth were more likely to be older, obese, have elevated cholesterol levels, a history of cancer, and a history of smoking, she points out–all of which don’t bode well for fertility or heart health.

And yes, there’s also the potential that the fertility medication itself can increase a woman’s risk of developing heart disease, women’s health expert Jennifer Wider, M.D., tells SELF. However, she says, more research is needed to figure out the connection. Dr. Wider was not affiliated with the study.

It’s really about taking care of your overall health.

Of course, that doesn’t mean women should simply undergo fertility treatments and hope for the best in the future. Some fertility specialists recommend that women get their overall health checked out before undergoing fertility treatment to make sure they’re in good health, and Shahin Ghadir, M.D., a fertility specialist at Southern California Reproductive Center, tells SELF that’s a good idea. His clinic recommends that all women have a physical examination within the year before trying to conceive, which includes an electrocardiogram (EKG) and blood work relating to the heart, liver, and kidneys. “Staying healthy at all times, especially during fertility treatments is very important,” Dr. Ghadir, who was not a part of the study, says.

Jennifer Hirshfeld-Cytron, M.D, an ob/gyn and reproductive endocrinologist at Fertility Centers of Illinois, tells SELF that women undergoing infertility care should also be encouraged to continue all routine medical testing, including physical exams and cancer screenings like Pap smears and mammograms, during the treatment process. And, she stresses, maintaining a healthy weight is crucial, since obesity can be a factor in both infertility and heart disease. “Check your BMI so you know where you fall on the spectrum,” she says. “If you are overweight or obese, vigorous exercise can decrease time to pregnancy and help achieve weight loss.”

Dr. Wider says the research also sends a message that women who didn’t have success with fertility treatments should tune in to their heart health. “One of the best things that came out of the study is a message to women who are undergoing fertility treatment to pay attention to cardiovascular risk factors as they age,” she says. That can include trying to maintain a healthy lifestyle by eating a good diet, getting regular exercise, avoiding smoking, and paying attention to blood pressure and cholesterol levels. Dr. Choi says she also encourages her patients to maintain a healthy BMI and reduce alcohol consumption when they’re trying to get pregnant–and Dr. Weinberg notes that all of these factors usually help improve heart health as well.

If you undergo fertility treatments and don’t have success, Dr. Weinberg says it’s “very reasonable” to see your primary care physician and ask for a cardiovascular assessment. That can include an EKG, blood pressure testing, a weight check, and cholesterol assessment. If your doctor finds a problem, you shouldn’t panic, but you should take action. “You can modify these risks so that you don’t have significant issues later,” Dr. Weinberg says.

Don’t skip fertility treatment based on the findings because more research is needed.

Women who are considering undergoing fertility treatments shouldn’t decide not to get them based on the study’s findings, Dr. Wider says. The study is correlational, meaning researchers found that there’s a link–not that undergoing fertility treatments necessarily causes heart issues–and more research is needed.

Dr. Choi agrees. “Understand that the absolute number of cardiovascular events in both groups of patients was quite low,” she says. However, she urges women to make sure that their health is in “optimal order,” not just for fertility treatments, but for pregnancy as well. “It’s a nine-month workout for your body,” she says. If you’ve already had fertility treatments, don’t freak. “Just because you get fertility treatments, you are not necessarily at risk–this is just one study,” Dr. Ghadir says.

Related:

  • These Subtle Symptoms Could Mean You’re Having a Heart Attack and Don’t Know It
  • 8 Reasons to See a Fertility Specialist
  • 6 Ways Infertility Impacts a Relationship

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